320,000 Lives Lost and Snail-Pace Political Progress Mark 15 Anniversary of AIDS Epidemic in America

June 5, 1996 sadly marked the fifteenth anniversary of a tragedy that has wrought alarming physical and social devastation in our nation: the AIDS epidemic. The history of this national tragedy is punctuated by the senseless deaths of hundreds of thousands of our loved ones and friends, by government intransigence in the face of a burgeoning epidemic, and by the excruciatingly slow pace of scientific advancement against a disease that has steadily sapped our nation of precious life, valuable resources and an irretrievable measure of hope and faith.

On June 5, 1981, the U.S. Centers for Disease Control and Prevention (CDC) published in its Morbidity and Mortality Weekly Report what would be the first report about the AIDS epidemic based on five unexplained cases of pneumonia affecting gay men in Los Angeles. Fifteen years later, the number of people afflicted by this disease has increased markedly, and the range of communities affected has expanded. Since 1981, more than 500,000 Americans have been diagnosed with AIDS, and more than 320,000 of them have already lost their lives. Once considered a disease almost exclusively of gay men, the reach of the epidemic now has expanded to include all people. AIDS is now the leading cause of death for all Americans aged 25 to 44. Women and people of color represent the
fastest growing groups of new AIDS cases: according to CDC statistics, women account for 19 percent of all AIDS cases in the United States, their highest proportion ever; and the incidence of AIDS among men of color continues its upward spiral.

A decade ago, despite the mushrooming number of deaths attributed to AIDS, the word "AIDS" remained a word our elected officials in Washington dared not utter, much less consider taking action about. It took individuals and communities united in tremendous grief and anger to force the federal government to engage in efforts to prevent the further transmission of HIV and to care for the already infected. The word "AIDS" today is a part of our national vocabulary. And, there now exists legislation specifically targeted to meeting the needs of Americans living with HIV/AIDS. Unfortunately, the politics of hatred, indifference, ignorance and prejudice remain viable threats to every hard-won gain we have achieved to date.

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Fifteen years into the epidemic, the need persists for the AIDS community to maintain its watch on, and wage battles against, a federal government that all too often seems to forget its responsibility to the millions of people who make up this great nation, regardless of HIV status. Incredibly, AIDS advocates still find themselves answering questions such as, "Why should we spend so much on AIDS care, prevention, housing or research?" And, subsequently, we find ourselves having to defend level funding for the federal Housing Opportunities for People Living With AIDS (HOPWA) program; and funding increases, however meager, for critical AIDS programs such as the Ryan White CARE Act, National Institutes of Health research or CDC prevention programs. There then
is our need to defend the 30-year-old Medicaid program from the misplaced priorities of a Congress bent on balancing its books at any cost, including the terrifying possibility that its "block grant-and-slash funding" Medicaid restructuring plans will shred the health care safety net that this program has come to represent to more than 36 million poor and medically needy Americans, including half of all people living with HIV/AIDS.

Equally troubling is the reality that in a day-and-age when national polls indicate more and more Americans know a loved one, friend or colleague who is living with HIV disease, the AIDS advocacy community continues to confront blatant discrimination against people living with AIDS -- discrimination that some in Congress continue to author and champion as principles that should be codified into the laws of this land. Less than two months ago, AIDS advocates rejoiced in their success in repealing from law an odious provision enacted as part of the 1996 Department of Defense Authorization bill which called for the discharge of 1,049 active duty service members because they are HIV-infected.

The celebration was cut short when, moments after the repeal, the provision's champion, Rep. Robert Dornan (R-Calif.), successfully attached a more egregious provision to the 1997 Department of Defense Authorization bill. Much to the chagrin of AIDS advocates and of HIV-positive servicemembers who traveled to Washington, D.C. to share their stories with our elected officials, the bill, complete with Dornan's extremist military HIV ban provision, was overwhelmingly passed by the U.S. House of Representatives.

The laundry list of grim statistics that outline the progression of this epidemic should serve to underscore the need for us to re-invigorate a concerted national effort against this disease at all fronts. Increased efforts are needed to educate all Americans about the reality of HIV transmission. Our HIV prevention messages must involve open and honest communication and must take into account social, cultural, gender and sexual orientation issues that are all too often ignored in prevention efforts. More research on the nature of HIV disease is critical, as are appropriate treatments. And, although every effort must be made to prevent the further spread of HIV and to search for a cure, it is equally important to treat and adequately care for those already infected.

The federal government must fulfill its responsibility to safeguard the public health, both by adequately funding HIV care, prevention, research and housing programs and by guaranteeing adequate and equal access to quality health care, including life-enhancing drugs and therapies, for all Americans living with HIV/AIDS. At this moment, Congress can demonstrate its commitment to fulfilling its public health responsibility by ceasing its year-long campaign to gut the Medicaid program, a program that has come to represent a health care safety net for more than half of all Americans living with AIDS.

But there is yet another responsibility that we all share in our battle to defeat this insidious disease. That responsibility is to stamp out the stigma and prejudice that surrounds AIDS. We can defeat Rep. Dornan's military HIV ban all we want but, in the end, if we do not tackle the very real civil rights issues related to HIV disease, we will continue to face many of the same challenges our community has faced for fifteen years. The decades-long battle against AIDS has taught us much, including the value of compassion and the importance of open and honest discussion about often-delicate social issues. Perhaps the greatest lesson, however, was the stark realization years ago that our fight against HIV disease is a test of our collective mettle as a society -- that
without an unwavering alliance between the American people and our public health, government and corporate leaders, there can be no end to the AIDS epidemic. Let us all heed that lesson and pray that our collective actions will lead to a day when we can all celebrate a world without the nightmare of AIDS.

Founded in 1984, AIDS Action Council is the only national organization devoted solely to advocating on federal AIDS policy, legislation and funding. AIDS Action Council represents more than 1,400 community-based AIDS service organizations throughout the United States.

José Zuniga is Director of Public Affairs at AIDS Action Council, the only national organization devoted solely to advocating on federal AIDS policy and legislation. Founded in 1984, AIDS Action Council represents more than 1,400 community-based AIDS service organizations throughout the United States.

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